Maternal Chronic Disease and Congenital Anomalies of the Kidney and Urinary Tract in Offspring: A Japanese Cohort Study
Maternal Chronic Disease and Congenital Anomalies of the Kidney and Urinary Tract in Offspring: A Japanese Cohort Study
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孕产妇慢性疾病以及后代肾脏和尿路先天性异常：一项日本队列研究
DOI：
10.1053/j.ajkd.2022.03.003
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发表时间：
2022
影响因子：
13.2
通讯作者：
et al.
中科院分区：
文献类型：
--
作者：
Nishiyama Kei;Sanefuji Masafumi;Kurokawa Mari;et al.
研究设计：一项全国性前瞻性出生队列研究。 背景和参与者：2011 年 1 月至 2014 年 3 月期间，15 个研究中心有 100,239 名儿童参加了日本环境与儿童研究。医生对母亲和儿童的诊断是通过病历笔录和调查问卷收集的。暴露：母亲非传染性疾病的病史，包括肥胖、高血压、糖尿病、肾脏疾病、甲状腺功能亢进、甲状腺功能减退、精神疾病、癫痫、癌症和自身免疫性疾病。结果：在出生后的前 3 年中诊断出 CAKUT。 分析方法：采用广义估计方程的多变量泊松回归，按临床中心进行聚类。结果：在 100,239 名儿童中，560 名 (0.6%) 患有 CAKUT，其中 454 名 (81%) 为孤立型，106 名 (19%) 为复杂型。患有肾脏疾病（调整后风险比 [RR]，1.80 [95% CI，1.12-2.91]）或癌症（RR，2.11 [95% CI，1.15-3.86]）的母亲的孩子发生孤立性 CAKUT 的风险增加。此外，患有糖尿病的母亲的孩子发生复杂 CAKUT 的风险增加（RR，3.04 [95% CI，1.64-5.61]）。局限性：缺乏临床定义、诊断标准、测量和测试的标准化或预先规定。未进行基因检测。结论：孤立性CAKUT和复杂性CAKUT与不同的孕产妇疾病相关。研究结果可为妊娠的临床管理提供信息，并突显孤立形式和复杂形式 CAKUT 起源的潜在差异。
Study Design: A nationwide prospective birth cohort study.Setting & Participants: 100,239 children enrolled in the Japan Environment and Children’s Study between January 2011 and March 2014 at 15 research centers. Physicians’ diagnoses in mothers and children were collected from medical record transcripts and questionnaires.Exposures: Medical histories of maternal noncommunicable diseases, including obesity, hypertension, diabetes mellitus, kidney disease, hyperthyroidism, hypothyroidism, psychiatric disease, epilepsy, cancer, and autoimmune disease.Outcomes: CAKUT diagnosed during the first 3 years of life, classified as isolated or complicated.Analytical Approach: Multivariable Poisson regression with generalized estimating equations accounting for clustering by clinical center.Results: Among the 100,239 children, 560 (0.6%) had CAKUT, comprising 454 (81%) isolated and 106 (19%) complicated forms. The risk of isolated CAKUT was increased in children of mothers who experienced kidney disease (adjusted risk ratio [RR], 1.80 [95% CI, 1.12-2.91]) or cancer (RR, 2.11 [95% CI, 1.15-3.86]). Furthermore, the risk of complicated CAKUT was increased in children of mothers with diabetes mellitus (RR, 3.04 [95% CI, 1.64-5.61]).Limitations: Lack of standardization or prespecification of clinical definitions, diagnostic criteria, measurements, and testing. Genetic testing was not performed.Conclusions: Isolated CAKUTs and complicated CAKUTs were associated with different maternal diseases. The results may inform clinical management of pregnancy and highlight potential differences in the genesis of isolated and complicated forms of CAKUT.